NCLEX · Grief, Loss, and End-of-Life

A client with terminal illness says, 'If I can just make it to my daughter's wedding next month, then I'll be at peace.' According to Kübler-Ross, which stage of grief does this represent?

Correct answer

Bargaining — negotiating with God, fate, or medical providers for more time in exchange for something; the 'if-then' structure is characteristic

  1. A Anger
  2. B Bargaining — negotiating with God, fate, or medical providers for more time in exchange for something; the 'if-then' structure is characteristic
  3. C Acceptance
  4. D Depression

Why this is the answer

BARGAINING is the third stage in Kübler-Ross's model, characterized by attempts to negotiate for more time, better outcomes, or a specific delay to the inevitable. The structure is typically 'if-then': 'If I can just see my daughter get married, then I'll accept this.' 'If I follow every treatment protocol, maybe the doctors can give me more time.' THERAPEUTIC APPROACH: Validate the wish and the meaning behind it (the wedding, the relationship); do not dismiss as denial or irrational; it often reflects what the client values and what gives life meaning; help the client plan for the event if medically feasible; gently explore what 'being at peace' means to them — this opens conversation about advance care planning and legacy; THE STAGES ARE NOT LINEAR: People move among stages, skip stages, and return to earlier stages; some people never reach acceptance; this model is a framework for understanding, not a prescription. BARGAINING IN FAMILIES: Family members also bargain — 'if we try one more treatment'; this can sometimes delay comfort care unnecessarily; the palliative care team can help families balance hope with realistic planning. PN ROLE: Meet the client where they are emotionally; support the meaning behind their request; coordinate with the care team about feasibility; document emotional state and coping.
Source: NCLEX-PN Test Plan: Psychosocial — Grief, Kübler-Ross Bargaining